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ANTEIS AESTHETICS SOLUTION
CHANGE STARTS HERE
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ANTEIS · CHANGE STARTS HERE 03
About Anteis Anteis is a leading Swiss innovator in next-generation injectable biopolymers based on hyaluronic acid, with a strong global presence in aesthetic dermatology. The company is active in three medical areas:
Dermatology
Ophthalmology
Orthopaedics
Anti-age treatments, including
Intraocular surgical devices for
Visco-antalgic for the
biodegradable wrinkle fillers
cataract and glaucoma surgery
treatment of osteoarthritis
and skin rehydration gels
With over 2.5 million syringes sold since 2005, Anteis is one of the fastest growing companies in aesthetic dermatology. The company has received numerous awards, including the Swiss Economic Award 2008 in recognition of its innovation, market leadership and quality, and the 2009 Gusi Peace Prize for its contribution to improving people’s wellbeing.
GUSI PEACE PRIZE
At present, Anteis Aesthetics Solution includes 4 distinct product ranges
Esthélis Basic & Soft
Fortélis
Modélis
Mesolis and Mesolis+
Smoothing all types
Filling folds and
Modelling and
Rehydrating and restoring
of wrinkles
deep wrinkles
restoring facial
the skin’s radiance and
volumes
elasticity
In addition, Anteis recently introduced the Anteis Injection System, a breakthrough technology for the highly precise, automated, local injection of gels, with greater comfort for patient and practitioner.
Anteis was founded in 2003 in Geneva, Switzerland and has its own in-house research & development department as well as an ISO-certified manufacturing facility in Lonay-Morges and a FDA-inspected manufacturing facility in Geneva, Switzerland. Anteis is represented in about 90 countries on 5 continents.
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ANTEIS · TECHNOLOGY 04
HA and cross-linking Hyaluronic acid (HA) is a natural component of connective tissue that provides firmness, elasticity and water retention. HA gels are widely used as dermatological fillers and have shown their superiority to collagen thanks to greater safety and longevity. Phase 1 Addition of pure hyaluronic acid
Because HA in its native form is quickly degraded in the body by enzymes and free radicals, it needs to be cross-linked to provide a long-lasting result. There are many ways to carry out this
CROSS-LINKING
cross-linking, and the clinical results differ widely.
Cross-linked HA gels can be produced in monophasic or biphasic forms. Biphasic gels are an older technology and contain microparticles dispersed in an aqueous carrier. They do not integrate Phase 2
so well into the skin and have a higher risk of causing side effects
Linearisation of hyaluronic acid
such as granulomas and hypersensitivity. Monophasic gels are uniform and contain no particles, and they have proven to be superior to biphasic gels for their safety and ability to integrate into the skin’s extracellular matrix. Anteis exclusively uses monophasic gels in its product range, using biofermented (non-animal origin) HA. Phase 3 First cross-linking of hyaluronic acid through the addition of BDDE
Anteis’s unique technology Dynamic cross-linking is a process patented by Anteis combining different density levels – polydensification – within a monophasic product. Anteis’ fillers are the only ones on the market being
DY N A M I C C R O S S- L I N K I N G
monophasic and polydensified.
Phase 4 Pulling of the first cross-linked level
Phases 1 to 3 The cross-linking procedure, based on these first three phases, has long been known. It was patented 20 years ago and is currently used in the manufacture of most of the other NaHa-based resorbable implants.
Phase 5
Innovative phases 4 to 5
Continuation with a dynamic second cross-linking with a supplementary addition of hyaluronic acid
These last two phases constitute the innovative part of the dynamic cross-linking technology patented by Anteis.
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05
Dynamic Cross-Linking Technology
Smoothing
Filling
Modelling
CPM
EVE
HPM
Cohesivity
Elasticity
Plasticity
Sub-cutis
Intradermic
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Cross-linking rate
Polydensification
The advantages of Anteis’s dynamic cross-linking technology are substantial and of great significance: • The denser parts contribute to a longer-lasting result. • The less dense parts make the gel easy to inject and enable it to be homogeneously integrated into all layers of the dermis. • The result looks and feels natural. • The products are very safe, with minimum side effects.
Anteis employs its dynamic cross-linking technology throughout its range of dermatological filler products and has achieved extraordinary results. Comparative clinical studies on volunteers have shown that Anteis’s monophasic polydensified HA gels are very forgiving, producing less clumping and a more homogeneous distribution than either the biphasic gels or monophasic monodensified gels commonly used by competitors.
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ESTHÉLIS · UNMATCHED WRI NKLES SMOOTHING & SU R 06
Esthélis is an injectable gel using Anteis’s dynamic cross-linking technology, intended for: • Filling all types of wrinkles
• Enhancing lip volume and contours
• Smoothing fine lines
• Correcting sunken scars
Esthélis comes in two highly purified forms:
Esthélis Basic
Esthélis Soft
• Superior level of HA
• Low level of HA
cross-linking (22.5mg/ml)
cross-linking (20mg/ml)
• For all types of wrinkles
• For fine lines
• Superficial to mid-dermis injections
• Superficial injections
Esthélis is the only highly cross-linked gel that allows: • incomparable dermal integration
• very superficial injection
• the most natural results
• use of less product
• minimal risk of side effects
• long-lastingness
This unmatched capacity is the result of cohesive polydensified matrix (CPM) technology, developed and patented by Anteis.
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U RFACE TREATMENT 07
Esthélis provides very natural-looking results with a homogeneous integration into the skin
CPM: Esthélis
Competitor 1
Competitor 2
Monophasic polydensified
Monophasic monodensified
Biphasic
Smoothly surfaced block
Not smoothly surfaced block
With micro-particles
without particles
Esthélis can be injected very superficially, requiring very little product. It maintains its volume for the first months after injection, making touch-ups and over-corrections Esthélis Basic
unnecessary, and has an average duration of 9 months, often lasting over a year.
Esthélis has a remarkable safety record, with not a single hypersensitivity reaction recorded nor any granulomas observed since its launch in 2005.
HA distribution in the dermis*
Control
114 days after injection of HA fillers, Alcan blue staining · Violet = HA
Anteis
Competitor 1
Competitor 2
Monophasic polydensified
Monophasic monodensified
Biphasic
The comparative biopsies demonstrated that: • Esthélis infiltrated the dermis homogeneously • Esthélis produced minimal dermal trauma or structural alteration
* Title of the study: "Distribution and biological effects of a monophasic polydensified cross-linked HA filler compared to monophasic-monodensified and biphasic gels injected in human dermis" · Investigators: Salomon D, Tran C, Micheels P, Gtand D, Carraux P · Study period: June 2007 - April 2008 · Number of patients: 15
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FORTÉLIS · EXTRAORDI NARY FI LLI NG & LI P VOLUME A 08
Fortélis is a resorbable gel with remarkable volume-enhancing power, intended for: • Filling deep wrinkles, folds and facial depressions • Increasing lip volume
Fortélis features Anteis’s patented cross-linking technology and is designed to provide Extra Volumizing Elasticity (EVE). Developed with a carefully defined cross-linking ratio and a
Fortélis resorbable gel
high concentration of HA (25.5 mg/ml), its level of elasticity is perfectly adapted for enhancing volume and filling deep wrinkles while benefiting from all the advantages of a monophasic fluid gel. Fortélis achieves its best results when injected into the deep dermis, maximizing the natural effect and avoiding possible defects in appearance. The results can last for up to a year.
Fortélis is extremely safe and has excellent tolerability: • Minimum inflammatory reactions observed • Low degree of immune reactivity
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AUGMENTATION 09
Excellent tolerability compared to other products A comparative clinical study* showed on a histological level the local reactions to injected resorbable HA-based gels:
L and P
L, P, eG
L
L and P
P
No blood cells
D30
Anteis
Competitor 1
Competitor 2
Competitor 3
Monophasic polydensified
Monophasic monodensified
Monophasic monodensified
Biphasic
• Histomorphologically
• Slight to moderate degree
• Severe chronic
• Severe chronic
of chronic inflammation
inflammation
inflammation
free from inflammatory
• Increased number of
reactions • Unremarkable immune reaction
• Dense infiltration of in
lymphocytes & plasma cells
flammatory cells (lympho-
and several granulocytes
cytes and plasmocytes)
• Dense infiltration of lymphocytes, plasmocytes & granulocytes
• Regular distribution
• Uneven distribution
• Uneven distribution
• Uneven distribution
of foreign material
of foreign material
of foreign material
of foreign material
The findings document no inflammation and a hardly detectable immune response for Fortélis. The remaining dermal fillers induced varying degrees of chronic inflammation as well as significant immune reactions.
Very high patients' and practitioners' satisfaction Between June 2008 and January 2009, a satisfaction survey on Fortélis was conducted on a worldwide scale. During this period, 175 practitioners evaluated the product and the quality of the results on 1161 patients. Fortélis obtained an average score of 8.75 out of 10, according to 11 criteria, by the 175 practitioners who participated in the survey, with an even greater appreciation of Fortélis when injected into the lips.
10.0
9.5
9.0
8.5
8.0 General
Folds/deep wrinkles
Lip volume
Contours
Immediate
Easy placement
Integration
Could see immediate
fil./vol. effect
of the implant
into dermis
fil./vol. effect
* Publications: Dr.A.Z.Taufig, A. Szöke,
W.Kühnel (2009) · Neue Strategie zur Erfassung intradermaler Reaktionen
nach Implantation resorbierbarer Dermalfiller · J Ästhet Chir 2009 2:29 – 36 © Springer Medical Publishing 2009
Reliefs
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MODÉLIS · VOLUME RESTORATION & MODELLI NG WITH O 10
Modélis is a resorbable bio-implant intended for: • Restoration of facial volumes (cheekbones, cheeks, temples, jaw, chin, nose) • Sculpting of facial reliefs
Modélis offers outstanding plasticity and malleability, due to its use of HPM (Hybrid Plastic Matrix) technology. With this technology, combined with a high concentration of HA (26 mg/ml), the polydensification process is pushed to the limit to create two extremely different densities of cross-linked gel within a monophasic matrix.
The HPM technology has several key benefits: • The denser parts are almost solid, providing a remarkable long-lasting volumizing effect. • The less dense parts are cohesive, ensuring the stability of the matrix, an absence of migration of the gel and ease of injection. • The extreme polydensification process gives Modélis unique plasticity characteristics, allowing the face to be shaped and sculpted as desired.
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H OUTSTANDING MALLEABILITY 11
Modélis HPM Technology Polydensification
Excellent bio-implantation
Very low ejection force
Modélis Rheological Properties & Benefits
Plastic
Elastic
Cohesive
Highly
Very
Long
No migration
malleable
Volumizing
Lasting
of the gel
Modélis allows a very comfortable injection force, even with thin needles or cannulas. It can be easily injected into the deep dermis, subcutaneously or in the upper periostea, and it produces a long-lasting result of up to 18 months. Due to its cohesiveness, the gel does not migrate, while its elasticity enables it to retain its shape as it is modelled.
Comparison of Modélis with other volumetric fillers Modélis has garnered praise from practitioners, with 100% of those surveyed* considering Modélis to be superior or equivalent to the main competitive products.
Comparison
Volume
Injectability
Placement
60
50%
40
50%
50%
50%
50%
50%
46% 36%
20 18%
* An open label and multi-centre clinical evaluation assessing the efficacy and safety of Modélis, a new hyaluronic acid volumetric medical device dedicated to facial volume restoration. 9 injectors from France, Switzerland, Thailand, Germany and Belgium.
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MESOLIS · REJUVENATION BY REHYDRATION 12
The Mesolis range is specifically designed for rehydration treatments and intended for: • Rehydration and restoration of radiance and elasticity to the skin • Application on the face, neck, “décolleté”, hands Skin rejuvenation treatments with Mesolis are especially indicated for treating damage due to aging as well as environmental pollution, smoking, sun exposure, hormonal imbalances or the side effects of aggressive aesthetic treatments.
The benefits include: • giving radiance, tone and elasticity to tired and dried out skin • smoothing away fine lines • preventing the formation of wrinkles • skin pre-treatment before the injection of fillers to increase the duration of the effect and create a smoother transition with the rest of the face • decreasing fatty mass in the dermis (cellulite)
The Mesolis products contain only ingredients naturally present in the body and come in two forms:
Mesolis
Mesolis+
• Contains HA (14mg/ml)
• Contains HA (18mg/ml) + glycerol, for enhanced rehydration
• For use on younger, less dehydrated skin
• For use on more damaged, more dehydrated skin
Both Mesolis and Mesolis+ use HA with a very high molecular weight, giving them extraordinary water-retaining power. As opposed to the other products in Anteis’s dermatological line, the HA used in the production of Mesolis and Mesolis+ is not cross-linked. It is therefore possible to use these gels with the “multi-puncture” (nappage) and “papular” techniques in the dermal-epidermal junction.
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Glycerol is combined with HA for a long-lasting hydration effect • Glycerol sets up more links between HA chains through hydrogen bonds and creates a more stable matrix that remains longer in the skin. Hydrogen bonds
Water molecule
Glycerol molecule
Glycerol strengthens the rehydrating power of HA
100.0
• through its own extremely high hydrating properties 10.00 G’ (Pa)
• by reinforcing the stratum corneum in its role as a barrier against water loss
1.000
• through the creation of a “protective mantle” around HA. 0.100
This shield protects it against degradation, in particular through resistance to free radicals, mechanical pressure
0.010 1000 HA with glycerol
2000
3000
time (h)
and thermal variations.
HA without glycerol
A recognized protocol adaptable to your patients’ expectations To guarantee long-lasting results and a high level of satisfaction, Anteis recommends a standardized protocol consisting of 3 first sessions spaced out of 2 to 3 weeks, followed by another session after 2 months and then at intervals of about 6 months. This protocol can nevertheless be revised depending on patients’ objectives: preventing wrinkles, complementing a wrinkle treatment, or benefiting from a simple “flash” of radiance in view of a special occasion. The Mesolis products are highly safe. Secondary effects are considered to be virtually non-existent.
Theoretical hydration level
Theoretical hydration curve during a Mesolis treatment
Day 0
Day 15
Day 30
Day 90
Day 270
1st injection
2nd injection
3rd injection
4th injection
5th injection
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ANTEIS · TRUST THE CONFI DENCE THAT COMES FROM E 14
Before
Before
Before
After
After
After
Indication
Indication
Indication
Treatment of naso-labial folds,
Cheekbones
Complete face wrinkles
eye rings and glabellar lines
treatment
Esthélis
“
I really appreciate the possibility of injecting so super-
result. My patients have been very pleased with
ficially to work very precisely and to get such natural
the results and I am impressed with this product.
…the general ergonomics of the product is perfect.
„
which makes it almost impossible to have a poor
„
and remarkable results. And my patients do applaud
Truly an injectable that is foolproof.
when they see the long-lasting results…
Dr Tibor Harmathy · General Practitioner · Canada
Dr Patrick Micheels · General Practitioner · Switzerland
“
The safest dermal filler available
“
I like using Esthélis because it gives reliable and
predictable results. In my opinion it is the safest dermal filler available and lasts longer than other
„
available products. There is an extremely high level
„
of patient satisfaction, negligible swelling and little post-treatment downtime.
Modélis
Dr Peter Bakaric · Cosmetic Physician · Australia
“
The first time I used it, I immediately appreciated
the fantastic lifting power of Modélis as well as the
“
ease of injection through relatively small gauge
stands out uniquely amongst other injectable
needles and cannulas. The product moulded easily,
hyaluronic acid compounds because of the ease
providing a smooth natural facial contour.
of injection and the unique injection technique
Dr Arthur Swift · Plastic Surgeon · Canada
I am pleased to endorse Esthélis. This product
„
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M EXPERIENCE 15
Before
Before
Before
After
After
After
Indication
Indication
Indication
Treatment of scar
Lip augmentation
Face contours, naso-labial folds and lip enhancement
“
“
I immediately appreciated the fantastic lifting power
Modélis is the volumizing product that gives me
the most satisfaction because it is easy to handle when injecting and it can diffuse in the tissues very homogeneously and very naturally. The quality of
„
the results lasts over the long term just like the patients’ satisfaction.
„
Dr Ghislaine Beilin · Aesthetic Doctor · France
Mesolis · Mesolis+
Anteis Injection System
“
effects of prolonged sun exposure. It really gives
“
my patients’ skin back elasticity and tone. Smokers
to traditional techniques. It offers a very uniform
…Mesolis+ is perfect to compensate for the
I have used the Anteis Injection System for
over a year now and I can’t imagine going back
who have quite ‘tired’ skin recover a radiance they
„
and predictable result with much less pain
haven't had for years…
perceived by the patient.
Dr Katarzyna Kwarecka · Dermatologist · Poland
Dr Ildiko Papp · Dermatologist · Hungary
“
…For dermis rehydration? I certainly vote for
„
Mesolis+. It's been my most positive experience for rejuvenation treatments these last 20 years...
Dr Anne Grand Vincent · Aesthetic Doctor · France
„
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ANTEIS INJECTION SYSTEM 16
The Anteis Injection System is an innovative, automated electronic system that helps to deliver unprecedented results. Developed after a careful analysis of the key objectives and needs of both practitioners and their patients, it is set to become the new industry standard. The system is suitable for all types of aesthetic treatments based on injectable gels, including the complete Anteis Aesthetics Solution range, and can be used for filling wrinkles and folds, modifying facial shape and volume and rehydrating the dermis.
Launched in 2009, the Anteis Injection System remains a novelty in the aesthetic market. It has proved its effectiveness in reducing pain during injection and also decreasing the amount of bruising, swelling and side effects commonly seen with other injection techniques.*
The Anteis Injection System allows for a very smooth and constant injection of product that does not overstretch the tissues and results in more consistent outcomes.
Key features • Delivers extremely natural-looking results • More homogeneous integration of the gel into the dermis due to a constant pressure • Less pain • Fewer side effects such as bruising, redness and swelling • Fast and easy to install
Advantages for practitioners • Significantly less muscle fatigue brought on by the automated injection process • Better control over the speed of injection • Accurate control of the volumes injected • Unmatched injection precision • Less product needed
* Results of clinical evaluations of the Anteis Injection System (November 2007 – August 2009) 8 injectors from France, Poland, Switzerland, Greece, Hungary, Latvia and Brazil, 193 patients
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The Anteis Injection System consists of three main parts: • foot pedal
• central unit
• hand-piece
It also comes with boxes of ready-to-use syringes adapted to the system.
The easy-to-control foot pedal allows the practitioner to select the way the product is delivered – either continuously, in “flow” mode, or via regular droplets, in “drop” mode – and the size of the droplets or the flow rate. The Anteis Injection System features breakthrough technology that helps physicians perform treatments more effectively and patients to experience greater comfort.
This unique system was distinguished with an honourable mention for product design by red dot in its 2010 international design competition.
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THE ANTEIS PRODUCT RANGE · FOR A GLOBAL AEST H 18
Esthélis Basic
Fortélis Extra
Needle /
Level of injection
cannula size
HA concentration
Volumes
Product
Esthélis Soft
Manual: 0.6 ml and 1 ml
Indications
Manual: 1 ml
AIS:
AIS:
5 x 1 ml
5 x 1 ml
20 mg/ml
22.5 mg/ml
25.5 mg/ml
30G 1/2
30G 1/2
27G 1/2
27G 1/2
Superficial dermis
Superficial to mid-dermis
Deep dermis
• Fine lines
• Medium to deep wrinkles and
• Folds and deep wrinkles
• Perioral lines
Average duration of results*
Manual: 0.6 ml and 1 ml
volume enhancement
• Reliefs and contours of the face
• Lip commisures
• Nasio-labial furrows
• Lip volume
• Crow’s feet
• Glabellar wrinkles
• Correction of facial depressions,
• Forehead lines
• Lip volume enhancement
• Correction of facial depressions,
• Correction of facial depressions,
either age-related or due to
either age-related or due to
injury (scars...)
injury (scars...)
Up to 12 months
Up to 12 months
* Several factors may influence the duration of the result: volume injected, patient's skin type, injection technique used…
either age-related or due to injury
Up to 12 months
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T HETIC TREATMENT 19
Modélis
Manual: 2 ml AIS:
Mesolis
Manual: 1 ml
5 x 2 ml
Mesolis+
Manual: 1 ml AIS:
5 x 1 ml
26 mg/ml
14 mg/ml
18 mg/ml + Glycerol
25G 1
Manual: 30G 1/2
Manual: 30G 1/2 AIS:
Cannula (manual): 22G 50 mm Cannula (AIS):
32G 1/6
25G 40 mm
Deep dermis
Superficial dermis and
Superficial dermis and
Sub-cutaneous
dermal-epidermal junction
dermal-epidermal junction
• Rehydration and recovery
• Rehydration and recovery
Upper periostea
• Restoration of facial volumes (cheekbones, cheeks, temporal zone, facial contours) • Sculpting
of tired dermis • For use on face, neck, décolleté, back of hands
• “Flash“ radiance heightener • For use on face, neck, décolleté, back of hands
• For facial fat loss (lipoatrophy)
Up to 18 months
of tired or dehydrated dermis
Depending on protocol
Depending on protocol
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DP01-86-01EN
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Anteis has created its own academy for plastic surgeons, dermatologists and aesthetic practitioners: the InjectNow Academy. The InjectNow Academy makes available to practitioners complete information supports on injection techniques and regularly organizes seminars that present injection protocols. For more detailed information on the programs offered and the dates of the next sessions, visit our website: www.injectnow.com
The Anteis InjectNow Academy (INA) – combining technique and technology
Anteis S.A. Chemin des Aulx 18 1228 Plan-les-Ouates Geneva/Switzerland
Tel: +41 (0)848 747 848 Fax: +41 (0)848 949 849 mail@anteis.com www.anteis.com
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